Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: An updated systematic analysis

Lozano, Rafael, Wang, Haidong, Foreman, Kyle J., Rajaratnam, Julie Knoll, Naghavi, Mohsen, Marcus, Jake R., Dwyer-Lindgren, Laura, Lofgren, Katherine T., Phillips, David, Atkinson, Charles, Lopez, Alan D. and Murray, Christopher J. L. (2011) Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: An updated systematic analysis. Lancet, 378 9797: 1139-1165. doi:10.1016/S0140-6736(11)61337-8

Author Lozano, Rafael
Wang, Haidong
Foreman, Kyle J.
Rajaratnam, Julie Knoll
Naghavi, Mohsen
Marcus, Jake R.
Dwyer-Lindgren, Laura
Lofgren, Katherine T.
Phillips, David
Atkinson, Charles
Lopez, Alan D.
Murray, Christopher J. L.
Title Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: An updated systematic analysis
Journal name Lancet   Check publisher's open access policy
ISSN 0140-6736
Publication date 2011-09
Sub-type Article (original research)
DOI 10.1016/S0140-6736(11)61337-8
Volume 378
Issue 9797
Start page 1139
End page 1165
Total pages 27
Place of publication Oxford, United Kingdom
Publisher The Lancet Publishing Group
Collection year 2012
Language eng
Formatted abstract
Background:With 4 years until 2015, it is essential to monitor progress towards Millennium Development Goals (MDGs) 4 and 5. Although estimates of maternal and child mortality were published in 2010, an update of estimates is timely in view of additional data sources that have become available and new methods developed. Our aim was to update previous estimates of maternal and child mortality using better data and more robust methods to provide the best available evidence for tracking progress on MDGs 4 and 5.

Methods: We update the analyses of the progress towards MDGs 4 and 5 from 2010 with additional surveys, censuses, vital registration, and verbal autopsy data. For children, we estimate early neonatal (0–6 days), late neonatal (7–28 days), postneonatal (29–364 days), childhood (ages 1–4 years), and under-5 mortality. We use an improved model for estimating mortality by age under 5 years. For maternal mortality, our updated analysis includes greater than 1000 additional site-years of data. We tested a large set of alternative models for maternal mortality; we used an ensemble model based on the models with the best out-of-sample predictive validity to generate new estimates from 1990 to 2011.

Findings: Under-5 deaths have continued to decline, reaching 7·2 million in 2011 of which 2·2 million were early neonatal, 0·7 million late neonatal, 2·1 million postneonatal, and 2·2 million during childhood (ages 1–4 years). Comparing rates of decline from 1990 to 2000 with 2000 to 2011 shows that 106 countries have accelerated declines in the child mortality rate in the past decade. Maternal mortality has also continued to decline from 409 100 (uncertainty interval 382 900–437 900) in 1990 to 273 500 (256 300–291 700) deaths in 2011. We estimate that 56 100 maternal deaths in 2011 were HIV-related deaths during pregnancy. Based on recent trends in developing countries, 31 countries will achieve MDG 4, 13 countries MDG 5, and nine countries will achieve both.

Interpretation: Even though progress on reducing maternal and child mortality in most countries is accelerating, most developing countries will take many years past 2015 to achieve the targets of the MDGs 4 and 5. Similarly, although there continues to be progress on maternal mortality the pace is slow, without any overall evidence of acceleration. Immediate concerted action is needed for a large number of countries to achieve MDG 4 and MDG 5.
Keyword Development Assistance
H1n1 Influenza
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Public Health Publications
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